Fresenius Medical Care · 6 days ago
Pharmacy Benefits Specialist
Franklin, TN
Full-time
Hybrid
Senior Level
5+ years expFresenius Medical Care is dedicated to providing high-quality healthcare solutions, and they are seeking a Pharmacy Benefits Specialist to manage patient prescription benefits and facilitate the case management process. The role involves working with patients, healthcare providers, and insurance companies to ensure coverage and develop action plans for therapy maintenance.
BiotechnologyHealth CareMedical Device
Responsibilities
Develops professional expertise; applies company policies and procedures to resolve a variety of issues
Assesses patient prescription benefits and needs and develops action plans that provides for the introduction and continuation of therapy
Maintains comprehensive understanding of the pharmacy benefit process including but not limited to financial assistance programs, insurance plans, and payer trends at a national, state, regional, and local level
Assists in obtaining insurance approval and proactively plans for maintenance of coverage
Works with patients, healthcare providers, insurance companies, and internal operations staff to drive outcomes
Works on problems of moderate scope where analysis of situation or data requires a review of a variety of factors. Can identify complex issues and develop a plan accordingly related to benefit coverage
Builds and maintains productive working relationships with internal and external customers
May provide assistance to junior level staff with general tasks that require a better understanding of functions, as directed by immediate supervisor
May refer to senior level staff for assistance with higher level problems that may arise
Escalates issues to supervisor/manager for resolution, as deemed necessary
Reviews and complies with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations
Assists with various projects as assigned by direct supervisor
Other duties as assigned
Qualification
Required
Bachelor's Degree required
5 years' related experience; or an advanced degree without experience; or equivalent directly related work experience
Knowledge of private payer, Medicare and Medicaid structure and systems require
Proficiency in CRM system
Strong verbal and written communication skills
Critical thinking and problem solving
Preferred
Healthcare, Social Work, or Nursing or a related field is a plus
Experience in patient assistance programs, social service support, case management review preferred
Knowledge of benefit verification and prior authorization processes
Company
Fresenius Medical Care
Fresenius Medical Care is a healthcare company that provides dialysis treatment for those with chronic kidney diseases.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$758.43M2025-11-17Post Ipo Debt· $579.5M
2025-07-21Post Ipo Equity· $4.86M
2020-02-25Post Ipo Equity· $6.07M
Leadership Team
Helen Giza
Chief Executive Officer
Joseph Turk
CEO of Care Enablement and Member of the Management Board of Fresenius Medical Care
Recent News
2025-11-19
Company data provided by crunchbase